Have you ever had joint pain? Common joints to hurt are shoulder, elbow, knee and ankle. Ever wondered what to do for your joints so you could lead a healthy, active life? A joint is any place where two bones meet. The upside of joints is that they provide flexibility and movement. The downside is conjunction can lead to dysfunction and pain.
Traditional Chinese Medicine (TCM) calls joint pain, Bi Pain or Painful Obstruction Syndrome. This includes pain, soreness, or numbness. Bi Pain is caused by an obstruction of Qi and Blood in the channels. Have you noticed pain can flare up in the cold or damp? Obstruction is caused by an invasion of Wind, Cold or Damp. A shortage of Nutritional and Defensive Qi allows the Wind and Cold to penetrate. Once inside the Wind and Cold obstruct Qi movement. Qi moves the Blood, without it the Blood congeals, and Painful Obstruction Syndrome develops. Interaction with weather plays a major role the cause of Bi Pain. When the climatic factors are temporary plus Nutritional and Defensive Qi are low, Wind, Cold, and Damp can invade and cause obstruction. Climatic factors experienced every day for long periods of time are not able to invade. (2 ) The body is able to adapt and protect itself.
However, Wind during unseasonable cold or warm, can easily invade the body. Damp and Cold can be as invasive as Wind. The overarching theme for staying well and in balance is maintaining harmony through moderation. Avoid excessive exercise or work. Cover up to protect against cold, or damp, or wind. Being moderate becomes more important as we get older. As the body ages, the Qi channels become undernourished and more prone to invasion. Accidents can cause an underlying area of weakness allowing Wind, Cold and Damp to invade years later. Emotions play a part in Bi Pain. Anger and resentment can cause a stagnation of Qi leading to Blood stagnation and finally Bi Pain. Sadness, grief, and shock deplete the Qi and Blood, leading to malnourishment of the channels and……Bi Pain. (1)
As with all herbal treatments getting the correct formula for the condition is key. Chinese herbalism can address different kinds of pain and even target locations. The following formulas are listed by their Chinese Pin Yin names. Many companies will use an English or a botanical name for the same formula with the Pin Yin listed less conspicuously.
Du Huo Ji Sheng Tang
Pubescent Angelica and Taxillus Decoction
This classic and very useful formula was first recorded in Important Formulas Worth a Thousand Gold Pieces almost 1,500 years ago (2). It was likely in use long before that time. The herbs in this formula make it best for Wind, Cold and Damp Bi Pain with weakness or deficiency. The location of the pain is the lower body. It is a warming formula which both tonifies and disperses. This formula is a good fit for someone who feels cold and heavy, has numbness, and lacks flexibility. Use Du Huo Ji Sheng Tang for low back pain, leg atrophy, knee pain, and sciatica. It is traditionally used to treat both osteoarthritis and rheumatoid arthritis.
Looking at the research on this formula confirms its effectiveness. Arthritis Research UK presents a study on treating knee osteoarthritis. Patients received a pharmaceutical or Du Huo Ji Sheng Tang administered once daily. Patients reported the same amount of relief from pain and stiffness from both treatments. The effects were slower to develop with the herbal formula. (3) A 2016 Chinese mouse and zebrafish study shows the formula to be effective for rheumatoid arthritis. It does this by inhibiting inflammation severity and promoting lymphatic drainage (4) . In another China-based study, New Zealand rabbits were surgically given osteoarthritis of the knees. I know, it makes me sad too, but it happened in 2011. Results showed that Du Huo Sheng Ji Tang kept cartilage from further wear (5) . This is particularly significant finding, osteoarthritis is a degenerative condition. In TCM terms it is based in deficiency. That is reflected in the breaking down of cartilage, there’s not enough material to rebuild. Du Huo Ji Sheng Tang restores the depletion and the cartilage stays strong.
Shu Jing Huo Xue Tang
Relax The Channels and Invigorate the Blood Decoction
This formula is also for the lower body with an emphasis on increasing circulation to assist joint health. Typically, Shu Jing Huo Xue Tang is used for lower limb neuralgia and/or pain, sciatic pain, arthritic knees, neuropathy, cervical pain, and weakness and/or stiffness in the lower body. It is particularly good for the knee joints. Shu Jing Huo Xue Tang is best used for excessive conditions, whereas Du Huo Sheng Ji Tang is for conditions based in deficiency. One could think of Shu Jing Huo Xue Tang as a younger person's formula.
Juan Bi Tang
Remove Painful Obstruction Decoction
This obviously named formula was first listed in Song Dynasty (960 - 1279) in Yang Family Formulas and later in a tome called Ancient Formulas From the Garden of Crimson Snow. This latter is not a missing chapter from Game of Thrones, but a reference part of the Forbidden City garden where the five Chinese flowering crab-apple trees once grew. After blooming the red petals covered the ground like so much crimson snow*.
Juan Bi Tang is similar to Du Huo Sheng Ji Tang in the treatment of Wind, Cold and Damp. Juan Bi Tang has a different location specialty, it treats the upper body. Use Juan Bi Tang for feeling heavy and stiff in the neck, shoulders, and upper back. Think of it for numbness in the extremities, and for spasms and pain in the shoulders and upper arms. Juan Bi Tang is the perfect formula for frozen shoulder that is worse with damp or cold weather. Upper body pain that is the result of either osteoarthritis or rheumatoid arthritis can be helped as well. On a molecular level, Juan Bi Tang addresses rheumatoid conditions. It regulates many physiological aspects connected with rheumatoid arthritis. These include the immune system, hemostasis, gene expression, platelets, signal transduction, and metabolism (8).
Si Miao San
Four Marvels Powder
Not all joint pains are cold in nature, some are hot and that’s where Si Miao San steps in. This formula targets lower body Damp-Heat. This condition presents as swelling and redness on the skin or joints on the legs or feet. Aches and pains with a sensation of burning that emerges from the bones and tendons on the skin or surrounding joints on the legs or feet are the results of Damp-Heat. Si Miao San treats the dread nemesis of the big toe joint: Gout.
The herbs in this formula regulate the blood circulation in the lower half of the body and encourage the fluid metabolism. These actions unblock the fluids relieving temporary pain and swelling of the joints in the legs, muscle atrophy, and numbness in the legs. The red and swelling which comes with Damp-Heat is also associated with inflammation. Research shows that Si Miao San is an anti-inflammatory(9).
Shen Tong Zhu Yu Tang
Drive Out Stasis From A Painful Body Decoction
The source text for this formula is called Correction of Errors among Physicians (1830). It is noted that Shen Tong Zhu Yu Tang “is often effective when conventional formulas for treating painful obstruction have failed.” (2) This formula addresses sharp pain anywhere in the body and generalized pain throughout the body that does not respond to treatment. Chinese clinical studies show good results, from pain relief to complete recovery in cases of osteoarthritis, rheumatoid Arthritis, low back pain, sciatica, and low back with leg pain. (11)
External Treatment
Putting something on the place that hurts is a natural tendency. Using herbal formulas helps to move out the stagnation which is causing the pain. Juan Bi Tang can be used externally as a bath or a wash for painful joints. Tiger Balm makes a patch that is good for joint pain, stiffness, muscle pain, and inflammation. Tiger Balm can also be applied in cream form. An Australian study found that when used for tension headaches Tiger Balm outperformed the placebo and worked as well as medication (14) . Not bad for a hundred-year-old formula. Yunnan Baiyao Arthritis Pain Relief Plaster is another product to consider when arthritis flares. Yunnan Baiyao Plastersare effective for general aches and pains of muscles and joint. It’s A good one to have in your first aid kit. Kupico Medicated Plasters are good for both muscular and joint Bi Pain, and traumatic injury. Plasters and patches should not be used on broken skin or if you have a skin allergy. Use according to instructions.
Other Articles
Corydalis for pain issues Turmeric is good for heathy joints
Use herbs wisely
Before taking any of these formulas consult with a knowledgeable practitioner. Chinese herbalism is based on treating the pattern of symptoms, not a western medical diagnosis. If you have questions or special considerations, please work with your practitioner. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. Serving size is according to instructions on the label or as per your practitioner. Feel better soon.
*These trees have long since died and been replaced with trees called Beijing Mock Oranges or Philadelphus pekinensis, which have white flowers.
References
1 The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs. Giovanni Manioca, Churchill Livingstone, 1994
2 Chinese Herbal Medicine Formulas & Strategies 2nd Edition, Scheid, Bensky, Ellis, Barolet, Eastland Press, 1990
3 Du Huo Sheng Ji Tang for Osteo Arthritis Teekachunhatean S, Kunanusorn P, Rojanasthien N, Sananpanich K, Pojchamarnwiputh S, Lhieochaiphunt S et al. Chinese herbal recipe versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomised controlled trial. BMC Complementary and Alternative Medicine 2004; 4:19–27.
4 Evidence-Based Complementary and Alternative Medicine Volume 2016 (2016), Article ID 7067691, 12 pages
5 Evidence-Based Complementary and Alternative Medicine Volume 2011 (2011), Article ID 571479, 7 pages
6 Zheng, Guang & Song, Mengmeng & He, Biao & Li, Xiaoqing & Luo, Jia & Lu, Aiping. (2013). Exploring the molecular mechanism of Juan-Bi-Tang for Feng-Han-Shi-Bi syndrome in rheumatoid arthritis. Proceedings - 2013 IEEE International Conference on Bioinformatics and Biomedicine, IEEE BIBM 2013. 77-79. 10.1109/BIBM.2013.6732769.
7 Shigeyuki Kanai, Norimasa Taniguchi, and Hideaki Higashino, Am. J. Chin. Med. 31, 879 (2003).
8 Zheng, Guang & Song, Mengmeng & He, Biao & Li, Xiaoqing & Luo, Jia & Lu, Aiping. (2013). Exploring the molecular mechanism of Juan-Bi-Tang for Feng-Han-Shi-Bi syndrome in rheumatoid arthritis. Proceedings - 2013 IEEE International Conference on Bioinformatics and Biomedicine, IEEE BIBM 2013. 77-79. 10.1109/BIBM.2013.6732769.
9 Yang J.-L., Wang J.-L., Huang F., Liu K., Liu B.-L. Modified Si-Miao-San inhibits inflammation and promotes glucose disposal in adipocytes through regulation of AMP-kinase Chinese Journal of Natural Medicines, Volume 12, 2014
10 Anti-nociceptive, anti-inflammatory and toxicological evaluation of Fang-Ji-Huang-Qi-Tang in rodents Yu-Chin Lin, Ching-Wen Chang and Chi-Rei WuEmail author BMC Complementary and Alternative Medicine The official journal of the International Society for Complementary Medicine Research (ISCMR)201515:10
11 Shen Tong Zhu Ru Tang various usages
12 Haihua Shu, Hideko Arita, Masakazu Hayashida, Liang Zhang, Ke An, Wenqi Huang, Kazuo Hanaoka, Anti-hypersensitivity effects of Shu-jing-huo-xue-tang, a Chinese herbal medicine, in CCI-neuropathic rats, Journal of Ethnopharmacology, Volume 131, Issue 2, 2010, Pages 464-470, ISSN 0378-8741
13) Treating Musculoskeletal Disorders With Chinese Herbal Formulas - Part 1: Acute By Jake Paul Fratkin, OMD, LAcAcupuncture Today September, 2012, Vol. 13, Issue 09
(14) Schattner, Peter & Randerson, David. (1996). Tiger Balm as a treatment of tension headache. A clinical trial in general practice. Australian family physician. 25. 216, 218, 220 passim.
